THE USE OF DIFFERENT DOSES OF VECURONIUM IN PATIENTS WITH LIVER DYSFUNCTION

The clinical neuromuscular effects of two doses of vecuronium(0.15 mg kg^-1 and 0.2 mg kg^-1) were investigated in 20 healthypatients and 20 patients with cirrhosis, and compared with previouswork in which vecuronium 0.1 mg kg^-1 was given under identicalconditions of anaesthesia and monitoring. Ten healthy patientsreceived vecuronium 0.15 mg kg^-1 and 10 received 0.2 mg kg^-1.Similarly, 10 patients with cirrhosis received vecuronium 0.15mg kg^-1 and 10 received 0.2 mg kg^-1. Vecuronium 0.1 mg kg^-1has previously been shown to have a somewhat shorter durationof action in cirrhotic as opposed to healthy patients. In thisstudy, vecuronium 0.15 mg kg^-1 was found to have a similar durationof action in both groups, and vecuronium 0.2 mg kg^-1 had a significantlylonger action in the cirrhotic group. It is suggested that vecuroniumshould be used with caution in patients with hepatic dysfunctionand that, in such patients, monitoring of neuromuscular functionis desirable.